4364 Nicols Rd - Inspection FormDate 07 1 2 71
1
Name
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitar y sewer
O Sump pump properly piped
No sump pump
Ci13 oI Davao
Residential Sanitary Sewer Service
Compliance Inspection
Owne /Occup Ent Signature
Time
/ : . op.
Disk #
Street Name
i-EJ-Lik]
For information call 651.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks (
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Propeity Owner
Length of Service:
Record Number
Time
Entered S..L.at
• ,ern
O pm
Pho7 /rl
' , - - /Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Yellow Copy: City of Eagan ' -5 ., .((' Pink Copy: SEH
Number
Correctly
Discharged
Notes .w.- ( d /� 7.;.. '�z Fro
'
i, ; '` ),,; 7
i
1.
— ri q w M.1 ()i9'/ e2( < le : x. / 12 .�
Total
Incorrectly
Unknown
Surly pumps
j
s
~ —
Foundation drains
Roof drains
,E
I.A.iS?Pri( A C.
Date 07 1 2 71
1
Name
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitar y sewer
O Sump pump properly piped
No sump pump
Ci13 oI Davao
Residential Sanitary Sewer Service
Compliance Inspection
Owne /Occup Ent Signature
Time
/ : . op.
Disk #
Street Name
i-EJ-Lik]
For information call 651.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks (
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Propeity Owner
Length of Service:
Record Number
Time
Entered S..L.at
• ,ern
O pm
Pho7 /rl
' , - - /Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Yellow Copy: City of Eagan ' -5 ., .((' Pink Copy: SEH
City o1 1 Ea Ft
Residentiat,`Sanitary Sewer Service
Compliance Inspection
Date (7,/ e 1i /o
Name " %� Y / -, , L Disk #
PID Number
! -louse Number ! Street Name _ ° V/! 47/
Alternative Mailing Address
For information call 651.470:2788
Compliance
f a - No foundation drain connection
PR No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
Time /
, bynerlficcupant Signature
6
IYarrl
0 pm
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer.
O Flexible sump pump piping
s `t9
✓ %�j' - .s r
Length of Service:
Yellow Copy: City of Eagan
Record Number
r . !
c
Phone _ ." / I 7-5 / ..^
Time • t✓ s s r O a
Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
Number of stacks Entered S. at
Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number Discharged
Unknown
Notes
Total
Correctly
Incorrectly
Sump pumps
— —
~�
Foundation drains
( ,__.
__ —.
"_ ___M
Roof drains
_.-.._ -----
City o1 1 Ea Ft
Residentiat,`Sanitary Sewer Service
Compliance Inspection
Date (7,/ e 1i /o
Name " %� Y / -, , L Disk #
PID Number
! -louse Number ! Street Name _ ° V/! 47/
Alternative Mailing Address
For information call 651.470:2788
Compliance
f a - No foundation drain connection
PR No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
Time /
, bynerlficcupant Signature
6
IYarrl
0 pm
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer.
O Flexible sump pump piping
s `t9
✓ %�j' - .s r
Length of Service:
Yellow Copy: City of Eagan
Record Number
r . !
c
Phone _ ." / I 7-5 / ..^
Time • t✓ s s r O a
Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
Number of stacks Entered S. at
Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH